Contralateral insertion method to treat herniation with device using visualization components

Abstract

A method for performing a selective discectomy is disclosed whereby a path for insertion of a tissue removal device is created by inserting a cannula with a flexible distal end position into an intervertebral disc by entering the nucleus at a point contralateral or anterolateral to a herniation site or entering anterior or anterolateral relative to the herniation site. The path is followed by a cutting device with a cutting window and either or both of the cannula or cutting device may be positioned at a site of herniation using all of any of control wires, a set of styli, viewable markings on a component and / or visualization devices.

Description

CROSS-REFERENCE[0001]This application claims the benefit of U.S. Provisional Application Nos. 60 / 886,860, filed Jan. 26, 2007; 60 / 887,997, filed Feb. 2, 2007; 60 / 892,498, filed Mar. 1, 2007; 60 / 896,226, filed Mar. 21, 2007; 60 / 945,521, filed Jun. 21, 2007; 60 / 945,518, filed Jun. 21, 2007; and 60 / 945,519, filed Jun. 21, 2007, which applications are incorporated herein by reference. This application further incorporates by reference patent applications filed on the same day herewith and identified as attorney docket numbers SAAL-005 and SAAL-007.FIELD OF THE INVENTION[0002]The present invention is drawn to a flexible surgical cutting device which is navigatable within a subject such as within the confines of the intervertebral disc and methods of using the subject devices for performing selective percutaneous discectomy.BACKGROUND OF THE INVENTION[0003]The intervertebral disc is composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus pulposus). T...

AI Technical Summary

Benefits of technology

[0040]Another aspect of the invention is to provide a flexible surgical cutting device which is capable of directly accessing a site of herniation without damaging the intervertebral disc at the herniation site.

Problems solved by technology

The proteoglycan and water from within the nucleus decreases which in turn results in the nucleus drying out and becoming smaller and compressed.

Additionally, the annulus tends to thicken, desiccate, and become more rigid, lessening its ability to elastically deform under load and making it susceptible to disc fissures.

Additionally, biochemicals contained within the nucleus pulposus may escape through the annulus causing inflammation and irritating adjacent nerves.

However, if conservative therapy offers no improvement then surgery is recommended.

However, minimally invasive techniques have been rapidly replacing open surgery in treating herniated discs.

However, as illustrated in FIGS. 1A and 1B, these prior art devices are typically rigid and therefore, only able to access the center of the nucleus and remove material along a linear path from the access point to the center of the nucleus (1).

As a result, the tissue removal is not performed at the site of the injury and thereby has limited effectiveness.

Furthermore, the rigid devices are typically able to treat only the L4-L5 disc and not the L5-S1 disc that is commonly the source of patient discomfort.

However, this direct approach to the disc herniation results in further injury to the already weakened disc annulus, thereby increasing the likelihood of subsequent herniations.

Therefore, the above methods are unable to access and treat most herniations at the specific site of injury.

As such, the above methods are designed to merely remove a portion of the nucleus pulposus within the center of the nucleus but do not specifically remove material from within the site of injury.

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